Skin cancer screening & treatment

Dermatology at Clinique La Prairie

NEW: Skin cancer screening and treatment

As with most cancers, early detection of skin cancer is extremely important. At Clinique La Prairie, we now offer skin cancer screening at dermatology consultations, as part of your check-up, or by appointment.

The most common forms of skin cancer are carcinomas. A carcinoma is a tumor in the top layer of skin that normally appears on uncovered areas of the body such as the face, neck, shoulders, forearms and the back of the hands and tends to affect people who are over 50. It is generally caused by long-term exces­sive exposure to sunlight. There are two types of carcinoma: basal cell and squamous cell. Basal cell carcinomas are the most common and the least serious. They develop slowly and always remain localized, although they can sometimes invade deeper tissues. Squamous cell carcinomas are more rare and sometimes develop on pre-cancerous lesions such as “ac­tinic keratosis,” on burn scars or on chronic wounds. Squamous cell carcinomas are more aggressive and may invade lymph nodes and spread to other organs.

Melanomas are less common than carcino­mas but more well known and dangerous due to their potential to metastasize. They are a proliferation of melanocytes, which are the cells responsible for producing melanin. Melanomas can develop at any age, but are more common in young people. They rarely occur in children, however, because they normally take many years to develop. Mela­nomas can appear on any skin surface. In men, they often occur on the trunk and in women, on the legs. They develop in two distinct ways: a small pigmented spot may appear on healthy skin, or an existing mole (known scientifically as “pigmented nevus”) may alter in appearance.

In Europe, there has been a constant rise in the number of cases of skin cancer, especially melanomas, over the last fifty years, as well as an increase in the number of related deaths. In France, for example, the incidence rate for melanomas doubles every ten years, and 100,000 new cases of skin cancer are now de­tected each year; 7,000 of these are melanomas, resulting in 1,500 deaths. In Switzerland, around 1,700 patients are diagnosed with a skin melanoma each year. They account for 5% of all cancer cases, making Switzerland (alongside Norway) the most affected country in Europe.

The main cause of melanomas is sun expo­sure, particularly during childhood. The risk is increased among people with fair skin, those whose skin is covered with atypical moles of more than 4-5mm in diameter, and those who have a family or personal history of melanomas.

As with most cancers, early detection of skin cancer is the key to a good prognosis. First, patients can examine themselves using the ABCDE method as a guideline:

• Asymmetry : only part of the mole has changed and stands out from the rest
• Border : the edges of the mole have become irregular
• Color : the color of the mole is not the same all over, with depigmentation and patches appearing
• Diameter : the mole has grown and exceeds 5mm (a bit less than a quarter inch) in di­ameter

Elevation or evolving over time : the mole is growing more protuberant and/or develop­ing quickly

Although melanomas can vary substantially in appearance, one or several of the above features is often present. A regular and thor­ough examination of moles can therefore often lead to very early detection. The later a skin cancer is discovered, the higher the risk of it being invasive and more difficult to treat. Any change in the shape, size or color of a mole should thus be seen as a warning sign, and a dermatologist should be consulted immediately. The same goes for an ulcerated skin lesion that won’t go away or a thick and hard crust on the skin that will not scar.

Clinique La Prairie patients are of course re­minded of these rules and principles of pre­vention during their dermatological examina­tion, which can be conducted at a separate appointment or as part of a check-up. People at risk (i.e., those with fair skin, numerous moles, congenital lesions, a family or personal history of melanomas, or high sun exposure) should be examined regularly.

The dermatological examination begins with a thorough visual inspection of the entire skin surface. If no anomaly is found, it stops there. If necessary, however, the doctor will use a dermatoscope, which magnifies the skin to between 10 and 70 times its size, to look more closely at certain lesions. If a suspicious lesion is discovered, a biopsy is taken or the mole is surgically removed to determine whether or not it is malignant.